Developing a Grounded Theory Model of Effective Factors and Consequences of Gender-Affirming for Transgender People and Those with Undifferentiated Gender in Iran

Abstract

Background: Transgender people and those who have an undifferentiated gender identity face various personal and social challenges due to their dissatisfaction with the gender role and the desire to behave differently from the gender role. Thus, focusing on this group of people is one of the issues in health and psychology. To this end, the present study aimed to explore more deeply the challenges and problems faced by this group of people. Methods: This qualitative study was conducted based on the grounded theory proposed by Corbin and Strauss on 15 members of social networks and the Association of People with Gender Dissatisfaction. The participants were selected through purposive sampling from among those with undifferentiated gender identities from childhood to adulthood. The data were collected via individual in-depth interviews with the participants. The collected data were analyzed using the systematic grounded theory approach to extract related categories and codes and develop a conceptual model. Results: The analysis of the data revealed 54 themes that were grouped into 9 subcategories and 5 main categories. Gender affirming was extracted as the core phenomenon. The causal factors included the feeling of living in another person’s body and problems in social relationships. Contextual factors were divided into 4 subcategories including family challenges, positive and negative public reactions, peer relationship problems, and economic challenges. The intervening factors were school problems and the role of media. In addition, the consequences were the positive and negative experiences of life in another body. Finally, the extracted strategies were support and individual coping strategies. Conclusion: Social factors and family and school play an important role in aggravating the problems of people with gender dissatisfaction. Focusing on empowering these people can help them adopt effective coping strategies. Besides, given the lack of recognition for people with gender dissatisfaction, raising public awareness of the challenges faced by these people is particularly important.